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Will IBM save the US Middle Class?

By DrScott – Posted on March 9, 2106

When I read the news of IBM’s acquisition of Truven Analytics last week I had to contain my excitement.  From my perspective, it is ground shaking to imagine the potency of IBM Watson Health gaining access to a significant cache of private and public healthcare data.  Let me explain.

The middle class in America has been under significant economic pressure from the impact of healthcare costs for years.  For well over a decade the significant gap between increases in income and increases in health care expenditures continues to widen. This is particularly important for those making less than $75K annually, where every dollar of disposable income impacts the quality of life.  In addition, it is commonly reported that medical bills are the #1 cause of bankruptcies, with a disproportional impact on the middle and lower classes.

Adding to this is the shift toward consumerism with strategies like high deductible plans, which increase the proportion of health care cost burdens on the individual. Consequences include higher individual costs and lower compliance with prescribed medications and interaction with the healthcare system.  These current circumstances are thus aggravating the problem pointed out by the Institute of Medicine in its landmark 2004 Crossing the Chasm report which concluded “we know what to do (medically), but are not doing what we know.”  This too targets those with the lowest ability to absorb the increased expense – the middle and lower classes.

These lower adherence rates notably affect primary (lifestyle & immunizations), secondary (pre-disease), and tertiary (disease) prevention efforts, where “doing what we know” has the potential to decrease the development, progression, and complications of disease, thereby saving billions of dollars, pain and suffering. Successfully accomplishing this would save individuals from needless cost, disease, disability and death – adding to the prosperity and productivity of the middle class.

So what does this have to do with IBM?  With the acquisition of Truven, coupled with the insight Watson Health can provide IBM in predictive analytics, and the addition of Phytel (more below), IBM can literally transform healthcare in America from the antiquated, dangerous, fragmented “system” we have now to the proactive, effective, life-enhancing, possibility.  Seem impossible?  Here’s how they’ll do it.

When IBM loads the Truven database into Watson, the world of “Watson Age” of predictive analytics will continue to evolve.  The relatively primitive use of “gaps in care” and the actuarial models that predominate today will be replaced by the ability to predict events and health changes not possible in the past.  Made available to individuals or groups of individuals, say a corporation, Medicaid, or Medicare recipients, informed individuals with the knowledge and confidence to choose, can reduce unnecessary conditions, cost, pain & suffering, disability, and death over a relatively short time (months to years).

If programs and systems were designed and taken to individuals in apps and programs; and if the incentives in health plan benefit design, whether government or private, were created to support individuals successfully achieving these recommendations, then the US Healthcare system could pivot from the most expensive, and one of the less effective systems to the highest value system in a matter of years. This would save literally billions of dollars in unnecessary care, unintended consequences of the care provided, and the provision of important care that remains undone in America today – a huge benefit to all Americans, and to the middle class particularly.

In addition, the ability to look at individual doctors, integrated delivery systems (IDNs), and accountable care organizations (ACO’s) with statistical power and new insights will be unparalleled in history.  Why is this so important?

Imagine for a moment that every doctor, IDN, and ACO had insight into their value to the system along the lines of quality, safety and cost.  While this initially may be disconcerting to the average doctor or health system, done properly, this information would be used to improve individual and organizational effectiveness, and potentially over time, to weed out those providers who are unwilling to meet acceptable benchmarks.  A necessary change to the #3 cause of death: the US healthcare system.

Over time these analyses would be made public to individuals who would then have the ability to factor in quality, cost, service, and safety into their healthcare decisions, finally making transparency a reality that empowers the individual healthcare consumer.

Also, don’t underestimate the power of the demographics embedded in the Truven database.  The ability to analyze and predict who will be compliant and adherent to healthcare recommendations, and to generate hypotheses and research to improve engagement and activation are also important.  Patient/employee engagement has been characterized as the “next billion dollar drug” and this lays the foundation for IBM to raise the stakes and effectiveness in this vital area.

IBM’s acquisition of Phytel a few months ago plays directly into this strategy with its proven effectiveness in providing individuals and providers with important information to improve and proactively manage their health, providing another crucial link in the chain of critical steps to transform healthcare.

From my perspective IBM’s strategy will work.  As a primary care doctor who struggled with proactive healthcare, I have seen the power of effective analytics when working with Jim May of Clinical Integration of North America (CINA); of effective outreach while working with Neil Smiley the founder of Phytel; linked to effective implementation in a primary care practice serving patients in north Texas (TienaHealth).  This was early in the 21st Century so it took a few years to design, but the resulting increase in effectiveness, efficiency, and patient satisfaction, the Triple Aim, were inspiring.

While this vision might sound naive or optimistic, it is possible.  The combination of Truven’s data and Watson’s insights creates the possibility of a new future that could result in an infusion of billions of dollars of discretionary income into the middle class.  While not solving the problem of job creation, education, healthier communities, and the other challenges facing the middle class today, it certainly would be a huge step in the right direction.

Automate Doctor’s Office

If I could get doctors and present it would be to automate their office. We rely so much on being able to handle the patient’s primary complaint, all the best, screen for common conditions, and do the national prevention guidelines. It’s just overwhelming and leaves to Johnston games. In this article points out how he Dr. Buehler in Venice Florida has automated process the screen for prediabetes. The effect of this for thepatience and for the medical system as a whole is significant and profound. In work you done with corporations the average savings for the corporation when their employees or screen and given support in addressing that won’t syndrome is hundreds of dollars per month. This initiative would strongly considering.
Here to me is the crux of the article; Before the pilot program, Dr. Buhler said her practice had no standardized protocol in place to screen for prediabetes. Now, she’s using tools from the AMA collaboration to screen her patients and refer at-risk patients to the local YMCA. One patient who recently started the program already has lost five pounds.
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AMA Wire®: How one physician is helping stop diabetes among her patients

Scott Conard, MD DABFM, FAAFP

Check out our new book:

The Art of Medical Leadership: A Guide to Identifying and Moving Beyond Common Leadership Mistakes

Defeating the Tyranny of the Urgent

Has the ‘tyranny of the urgent’ slowly crept in and overtaken your “purpose driven’ focus? Suzan Oran’s Life Design course (bit.ly/S91Rm7) was a well done, provocative, succinct re-focusing on what really matters. Her use of distinctions, (explorations in how one is holding, or thinking about an issue) is very different than learning or memorizing coursework. Distinctions actually clean lint out of our filters rather than adding more lint through coursework and memorization. I strongly recommend her June 2nd course for every person regardless of what they are up to in their lives.

How is Your New Year’s Resolution Coming? This Year it is Time to Succeed!

First in the How to Switch On Your Employees Series

What is your New Year’s resolution? If you are like most Americans, the resolution will be given up by Super Bowl weekend and things will be back to status quo. But what if things were different this year? What if you succeeded and lost that weight, got in shape, or saved that m oney? What if 2014 became the year to get things done in a way you have never experienced before? What would you have to do differently in 2014 compared to previous years?

The science of change management, which is what we are speaking about, has come a long way in the past 5 years and it’s time to incorporate these discoveries into achieving our goals.

Let’s start by asking: is knowing what to do enough? As a weight loss expert who has helped hundreds of people lose weight, it is clear that there are many patients who can literally recite encyclopedic knowledge on calorie balance, exercise, food labels, and the latest best seller’s strategy on effective weight loss, but they don’t lose a pound. They know what to do, but are not doing what they know.

Maybe the key is to create or overcome strong emotional issues. In the patients mentioned above, often a life event preceded the significant weight gain. When this occurs there is no question that getting in touch with “what happened” and re-framing the experience in a more empowering and less threatening way makes a difference. However, often there was no preceding trauma or the traumatic experience was resolved through beneficial and significant counseling but no weight loss occurred, suggesting that attention to emotional issues may not be enough by itself… To continue reading click here

How Regularly Are You Exercising? 2014 May Be The Time To Start

To stay up to date on the latest information I listen to the Massachusetts Medical Society Journal Watch.  They say medical knowledge doubles every 9 months these days so it is important to stay on it! 

I thought you might enjoy this summary on exercise;

Robust midlife cardiovascular fitness is associated with lower heart related disease, but what about death? To answer that question, researchers evaluated the associations between fitness and several chronic conditions (namely, ischemic heart disease, congestive heart failure, stroke, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and lung or colon cancer) in older patients by linking a preventive medicine registry to Medicare data. Nearly 20,000 patients got full baseline fitness and medical evaluations and were stratified into five groups based on their fitness level (the patients’ average age at study entry was 49; most were men). A good number of the patients had relatively favorable cardiovascular risk profiles at study entry. Findings appear in the September 24 Archives of Internal Medicine (http://viajwat.ch/WhxcCO).

During a median follow-up of 26 years, the patients who were most physically fit had about half of the prevalence of chronic conditions than did those who were least physically fit. In adjusted analyses, each Met (metabolic equivalent) increase in baseline fitness was associated with a roughly 6% reduction in risk for developing a chronic condition.

Although these results on midlife cardiovascular fitness being a predictor of healthy aging are not surprising, they add another motivation for encouraging midlife fitness: This approach can lower the risk for frailty and comorbidities while improving quality of life for older people. 

Here is to aerobic exercise at least every 48 hours in 2014!  Happy New Year.  SC


We are proud to announce the opening of our new Dallas Clinic, located at 6211 W. Northwest Hwy., Ste. C255, Dallas, TX 75225.  Along with our new location, we are excited to welcome Sue Thomas as our new practitioner!

Sue Thomas RN, MSN, FNP-BC has been impacting the lives of others in healthcare since 1994.  Sue earned her Bachelor’s degree in nursing from Mt. Mercy University in Cedar Rapids, Iowa, and earned her Masters of Science degree in nursing from Baylor University in Dallas, Texas, specializing in family medicine.

Sue has been in practice as a Nurse Practitioner for 13 years in the Dallas metro area, and has built a reputation for her excellent diagnostic skills and thorough level of care.  She has an innate ability to be caring and compassionate and is able to develop strong bonds with patients of all ages.

Sue is an accomplished speaker on the topics of hormones, diet and exercise, and fatigue.  She is also cross-trained in aesthetics and is able to provide exceptional skin care through injectable treatments, such as Botox/Juvederm.  She serves as a clinical instructor at the National Laser Center in Dallas, Texas as well as at Baylor’s nurse practitioner program.  She is known for her gentle touch and critical eye and has superior patient outcomes.

Sue is an avid marathoner and triathlete.  She has been happily married for over 18 years, and she and her husband have three lovely daughters.

We look forward to providing your health care needs at our new location!

Is Sugar Leading To The Collapse Of Our Society?

One of the most interesting and controversial issues in medicine today is the effect refined carbohydrates, such as table sugar, has on our bodies. In his book Sugar Blues, William Duffy got this controversy going with his proclamation that the introduction of sugar has led to the collapse of every great society from Egypt to the present day. While many medical experts viewed this as fringe sensationalism, the publication of the book Sugar Busters! by H. Leighton Steward, Morrison Bethea, MD, Samuel Andrews, MD, and Luis Balart, MD, rekindled the flame.

Whether Duffy’s claim is totally on target or not, the dramatic increase of refined sugar consumption and starchy foods by Americans is very con- cerning. According to the U.S. Department of Agriculture, the average American ate 5 pounds of sugar per year in 1900. In the year 2000, the estimated average sugar consumption per person was 163 pounds. That’s a 3,260 percent increase in 100 years! Our sweet tooth is definitely out of control.

– excerpt from “The Seven Numbers pg. 91″

Please watch this amazing animated short film about the effects of sugar on today’s families, featuring an original song by Grammy-award-winning singer songwriter Jason Mraz.


Take action and save lives today!

High Blood Pressure Effects Shocking Number Of Americans

According to Centers For Disease Control and Prevention an estimated 68 million Americans have high blood pressure, which is approximately a third of the adult population. With such a massive number of people suffering from the disease it is critical that people educate themselves about the disease and have their blood pressure checked regularly.


“The sobering fact about high blood pressure is that it is often without symptoms until it is too late. That is, until an “end organ,” such as our brain, kidneys or heart, becomes damaged, we rarely feel it… Many times the first sign that the silent killer has invaded our body is when we experience kid- ney failure, an aneurysm, a stroke or a heart attack.” — The Seven Numbers pg. 113

Don’t wait till it’s too late! Visit your doctor and make sure that you’ve got it under control. Fortunately, high blood pressure is a disease that can be controlled.

Interview With David Emerald & Dr. Scott Conard

by Moira McCarthy

David Emerald is known for his take on how to take positive control in your life. Most thought of for his TED (The Empowerment Dynamic) program, he’s an expert in helping folks in all kinds of situations shift from feeling like “victims” to becoming “creators” of their own positive destinies.

So when a doctor told him he’d been diagnosed with type 2 diabetes, one would assume he’d face the news like an empowered “creator.” But Emerald, who remembers the moment as if it just happened, said his response went something more like this:


“I was flabbergasted,” he says now, seven years later. “I teach and coach people around being the creator (of their own destiny) and there I was, feeling very much the victim.”

That, he said, is how overwhelming a diagnosis of type 2 diabetes may be.

While Emerald continued teaching his program, in his personal life and treatment, he slipped into all the things he taught others not to do: Instead of viewing his doctor as a coach and supporter, he looked at him to be a rescuer. And instead of working toward a place of positive movement, he felt himself deep in what he calls the drama triangle. In other words, he was far from practicing what he preached.

Enter Dr. Scott Conard. Conard, president of the North Texas American Diabetes Association, had seen Emerald in action at one of his seminars and had begun integrating Emerald’s TED concepts into his medical practice, particularly among those living with diabetes who are part of his practice. Finding himself in Emerald’s hometown, Conard headed to his house for a visit. As they talked, Conard shared what he was doing with TED, especially as it related to diabetes. Emerald could hardly believe his ears. He told Conard of his recent diagnosis, and shared his fears and stress, expecting perhaps some coddling. What he got, instead, was his own doctrine, given right back to him.

Click here for the entire interview on http://diabetes.sanofi.us/


Innovative Heart Rate Monitor For The iPhone

Have you ever wanted to check your resting heart rate but given up because you couldn’t feel your pulse or didn’t have a stopwatch to time the beats? Well never again if get Azumio’s “Instant Heart Rate” app from the iTunes App Store. This app actually uses the iPhones camera flash along with the camera to detect the vessels pulsing in your finger. I must admit that I was skeptical when I heard about this app. I mean could it really be that accurate? I discovered first hand that it is. At least it was for me. It really is slick the way that it works. And a bit mesmerizing as you watch your pulse being detected on the iPhone’s screen.


As you can see from the above video demo this little app can be a great fitness companion, providing yet another way to assess the effectiveness of your workout and diet plan.

For more information visit: http://www.azumio.com/apps/heart-rate/

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